Larynx Disorders

Many diverse events, circumstances, physical conditions, and diseases can result in voice abnormalities. The majority of voice issues are brought on by simple, easily curable, and non-life-threatening causes. However, a persistent voice problem should be checked by an otolaryngologist (ENT specialist) as there can be significant reasons for voice difficulties, such as laryngeal cancer. The vocal cords are located in the larynx. The larynx is essential for the body's ability to produce sound. There is no single symptom connected to a particular laryngeal condition; instead, almost every issue with the larynx, also known as the voice box, may cause many symptoms. For instance, a variety of laryngeal problems can manifest as hoarseness, limitations in pitch and loudness, shortness of breath, or greater vocal effort. It's not always the case that the intensity of the voice symptoms matches the severity of the underlying illness. Only by having an otolaryngologist assess your voice can you determine what is specifically causing your voice issue.

 

Where is Larynx Located?

As people age, their larynx positions change. It is located behind the jaw during infancy, between the epiglottis and the soft palate, the posterior portion of the mouth's roof. When someone swallows, a little piece of cartilage called the epiglottis closes up the windpipe. The larynx moves down the throat and backward as a person ages. In an adult, it is located midway down the neck, above the trachea (windpipe), and below the epiglottis.

 

Larynx Disorder Types

Some of the most prevalent laryngeal disorders are brought on by vocal cord strain or damage caused by constant talking, throat clearing, coughing, smoking, screaming, singing, or speaking too loudly or too softly. Regular vocal abuse and overuse can eventually lead to long-lasting alterations in vocal function and even voice loss. Abuse, misuse, or overuse-related disorders include:

Laryngitis. It is a vocal cord inflammation or edema.

Vocal cord nodules. on the vocal cords, tiny, benign (noncancerous) growths. One of the most prevalent vocal problems is nodules. Nodules frequently affect professional singers and anyone with high vocal demands.

Arytenoid granuloma. A benign growth known as a granuloma may occasionally form along the back of one or both vocal cords in adults. It may hurt to talk or swallow when this growth is big, and if it gets big enough, it might stop the vocal cords from correctly closing during voice production.

Reinke's edema. The disorder polypoid corditis, commonly known as Reinke's edema or smoker's polyps, causes the vocal cords to grow diffuse polyps, which make them feel heavy and ponderous. It usually occurs as a result of years of acid reflux and smoking. The vocal cords' increased mass causes them to vibrate more slowly while speaking, giving rise to a lower voice pitch. On the phone, women with this disease frequently lament being mistaken for men. Because it frequently results from smoking, polypoid corditis is a benign condition in and of itself, but it can also coexist with either vocal cord dysplasia (pre-cancer) or vocal cord malignancy. Additionally, the laryngeal airway may become restricted in severe cases, making breathing difficult.

Vocal cord polyps. Though softer and more blister-like, it is comparable to a vocal nodule. This issue is common among heavy smokers and is frequently caused by vocal fold damage.

Vocal cord hemorrhage.  A sudden loss of voice is frequently brought on by shouting, screaming, or doing other difficult vocal tasks.  A hemorrhage occurs when one or more of the blood vessels on the vocal cord's surface burst, causing the vocal cord's soft tissues to swell with blood.

Spasmodic dysphonia. One or more laryngeal muscles may move involuntarily in those who have this disorder. Speech problems or the perception that the patient's voice is sometimes tight, choked, or breathy can result from this.

Laryngeal papillomatosis. These wart-like tumors develop within the vocal cords, larynx, or the part of the respiratory system that connects the nose to the lungs. The human papillomavirus (HPV) causes the lesions, which can grow very quickly and commonly return despite careful therapy. If the patient's airway is obstructed, this could result in breathing difficulties; however, hoarseness is more common if they are on the vocal folds. People of all ages can develop laryngeal papillomatosis.

Vocal cord paralysis. The vocal cords do not correctly open or close. Vocal cord paralysis can impair speech in addition to causing coughing and difficulties swallowing because food or liquids may enter the trachea (windpipe) and lungs. Although a breathy, weak voice is frequently the primary symptom, vocal cord paralysis symptoms can occasionally be more severe. An injury to the neck, previous neck or chest surgery, cancer, a viral infection, or neurologic diseases like Parkinson's disease can all contribute to the disorder's development.

Laryngopharyngeal reflux disease (LPR). also known as gastroesophageal reflux disease (GERD), acid reflux disease, or heartburn. A flaming sensation in the chest that might happen after eating, bending, stretching, working out, and lying down is known as gastroesophageal reflux. When stomach contents rise back up into the esophagus, GERD happens. This can occur when the lower esophageal sphincter (LES) valve, which regulates how food travels from the esophagus to the stomach, malfunctions and does not properly close. Larynx-related symptoms from reflux include coughing, hoarseness, irritation, and sore throat. In these circumstances, it is known as laryngopharyngeal reflux disease (LPR). LPR may cause laryngeal cancer due to continuous irritation, but it is more frequently linked to frequent coughing, throat clearing, an abundance of mucus and phlegm, and a lump feeling in the throat.

Laryngeal cancer. Although various growths can affect noncancerous tumors, the larynx can also develop cancerous tumors. Squamous cells are the cells that line the innermost layer of the larynx. Squamous cell carcinomas, which are the most common type of laryngeal cancer, start in these cells. Laryngeal cancer can metastasize (spread) to surrounding lymph nodes in the neck if it is not discovered in its early stages. Smokers are more likely than non-smokers to develop laryngeal cancer. Alcohol consumption while smoking increases the danger even further. Laryngeal carcinoma is fortunately fairly curable if discovered early. An ENT specialist should be consulted if hoarseness persists for more than three weeks because it is an early sign of this form of malignancy to experience constant hoarseness while speaking.

Laryngeal stenosis is a narrowing of the airway that can make breathing difficult. Infection, neck injury, or intubation (placement of a breathing tube) are possible causes.

Dysphagia. Those who have this illness have trouble swallowing. Some dysphagia sufferers may find it difficult to swallow liquids, solid foods, or even saliva. Dysphagia is frequently observed in stroke patients, but it can also happen after neck surgery or radiation therapy for head and neck tumors. Reflux, muscle problems, benign or malignant growths, or scarring are some more causes.

 

Laryngeal Problems Symptoms

Depending on the cause, larynx diseases can cause a variety of symptoms, such as:

• Hoarseness
• Loss of voice
• Throat pain
• Raw tenderness at the back of the throat
• An ongoing urge to clear the throat
• Breathing problems.

 

Larynx Disorder Diagnosis

Flexible laryngeal endoscopy. An ENT specialist will use an endoscope, a small, flexible medical instrument with a light attached, to inspect the back of your throat during this test. The endoscope will be used to look at the larynx. At one end, there is a camera and light, while at the other, there is an eyepiece. Your doctor has a clear view of the inside of your nose and throat thanks to the endoscope. To allow the specialist to view your upper airways, including your larynx, from above, this is inserted through your nose. Although it could be a little unpleasant, you can first have your throat numbed with an anesthetic spray. Your doctor could advise doing a biopsy (the removal of a tiny sample of tissue) if they discover a problem with your larynx. 

Vocal cord video. This examination is also known as a video laryngoscopy. The larynx and vocal cords are tested when you speak. It makes use of an endoscope, a thin, flexible tube with a camera and a fiber optic flashlight on the end. The tube will be inserted by the doctor either through your nose or your throat. To numb the area, they can spray local anesthetic. You'll be prompted to speak. The test gives the professional a clear picture of the area and enables them to see your vocal cords moving slowly. You will be referred to an ENT physician, also known as an otolaryngologist if your doctor has a suspicion that you have laryngeal or hypopharyngeal cancer. An otolaryngologist will perform a complete examination of your head and neck. This will involve a laryngoscopy or examination of the larynx and hypopharynx. 

Flexible laryngoscopy. During this examination, the doctor inserts a fiber-optic laryngoscope through the nose or mouth to view the larynx and surrounding areas. This is a quick office procedure that uses topical anesthesia. The nasopharynx, the area of the throat behind the nose, the mouth, the tongue, and the neck are all thoroughly examined and felt for any indications of cancer in patients who have laryngeal or hypopharyngeal cancer due to their increased risk for developing other head and neck cancers. You might undergo a fine needle aspiration (FNA) if your doctor can feel a lump in your neck. This entails inserting a remarkably fine needle inside the lump. First, the specialist will feel the lump to determine where to insert the needle. They collect cells and fluid after inserting the needle into the bulge. To determine whether the cells are malignant, they send them to the lab for testing. Ultrasound is sometimes utilized to assist in precisely positioning the needle.

 

Diagnosis of GERD

From your list of symptoms, your doctor might be able to determine if you have gastroesophageal reflux disease (GERD). Additionally, the doctor can recommend testing to rule out other potential reasons for your symptoms, to keep track of the degree of the impairment, or to figure out the best treatment plan for you. A barium swallow or upper GI series involves consuming a chalky liquid that coats and fills the interior lining of your digestive tract to get an X-ray of your upper digestive system. The upper digestive tract is next imaged using X-rays. Your esophagus, stomach, and upper intestine (duodenum) can be seen in silhouette by your doctor thanks to the coating. Endoscopy is a procedure that allows you to see inside your stomach and esophagus. A thin, flexible tube (endoscope) with a light and camera is inserted down your throat by your doctor during endoscopy. Oropharyngeal pH probe testing measures the pH at the back of the throat over the course of 24 hours to determine whether reflux is a contributing factor to symptoms. The majority of the time, a laryngopharyngeal reflux diagnosis is made after observing irritation or swelling in the throat, more specifically in the back of the larynx. The majority of the time, the diagnosis can be made without additional tests. Three frequently utilized tests are available if testing is necessary. The esophagus, stomach, and intestine can be seen clearly on an x-ray during a barium swallow study. Passing a special kind of scope via the mouth and into the upper region of the throat is another technique used to diagnose LPR. The amount of acid in the throat is measured using the third test.

 

Larynx Disorder Treatment

The cause of laryngeal and vocal issues will determine how to treat them. For instance, laryngitis treatment may be as straightforward as frequent rest and hydration. Numerous drugs can be used to treat laryngeal issues. You might require medication to address gastric reflux, see a speech therapist, or have a lesion excised depending on the source of your condition. You can be directed to a smoking cessation program if smoking is the cause of your issue. Especially if detected early, laryngeal and hypopharyngeal cancer can frequently be successfully treated. Laryngeal and hypopharyngeal cancer can be treated primarily with radiotherapy, surgery, or chemotherapy. Cancer may be treated with one of these treatments or a combination of therapy. The most popular forms of treatment for both laryngeal and hypopharyngeal cancer are surgery and radiotherapy. Radiation therapy and chemotherapy can be used to boost the chance of killing cancer cells. The overall treatment plan for a patient with cancer is frequently created in collaboration between several types of doctors and other professionals, incorporating various types of treatments. An interdisciplinary team is what this is. Before any treatment starts, each professional should do an evaluation. The medical and radiation oncologists, the surgeons, the otolaryngologists (ENT specialists), the maxillofacial prosthodontists (specialists who conduct restorative surgical procedures to the head and neck areas), the dentists, physiotherapists, speech pathologists, and audiologists may all be a part of the team. Pathologists and diagnostic radiologists contribute to diagnosis and staging, making them essential parts of the treatment team.

 

Gastroesophageal Reflux Disease (GERD) Treatment

Over-the-counter drugs that reduce acid are typically used as the first line of treatment for heartburn and other GERD symptoms and signs. If you don't feel better after a few weeks, your doctor can suggest other therapies, such as prescription drugs. Surgery may be advised in severe cases and those that do not improve with treatment. If you have GERD and asthma, treating your GERD may help you manage the symptoms of your asthma. Studies have demonstrated that individuals with GERD and asthma experienced a reduction in asthma symptoms (and the need for asthma medications) following the effective management of their reflux disease.

 

How to Prevent Larynx Disorders?

You can take several steps to protect your larynx from illnesses and other disorders. These consist of:

• Eliminating unhealthy lifestyle habits. Giving up smoking and drinking less alcohol can help avoid laryngeal cancer.
• Not straining your voice. Polyps and nodules can be avoided by taking the necessary measures not to overuse or misuse your voice. If you speak a lot, this is very crucial. Lawyers, instructors, and singers are a few professions where speaking or singing frequently may cause voice strain. It's crucial to give your voice some rest, stay in good health with regular exercise, and keep any annoying factors under control. Allergies or acid reflux are examples of these issues.

If you consult your healthcare provider as soon as you start to have symptoms, the majority of larynx-related diseases are curable. Because some illnesses might harm your larynx and voice permanently, it's crucial to call your provider if you experience anything out of the ordinary.

 

Conclusion

The vocal cords, which enable speech, are located in the larynx (voice box). Cancer, growths, and laryngitis are among the larynx disorders. The larynx is frequently affected by vocal abuse, such as excessive screaming, singing, or shouting.